Ecole Connaught secretary Janine Jackson is given some baking after being nominated through Creative Options Regina’s 100 Acts of Kindness campaign, which recognizes people for their work and contributions. (CBC News)

Parking enforcement officers, drive-thru cashiers and university students are just a few of the people who have been recognized by a Regina group for the often unheralded work they do.

“It gets kind of heavy during the winter months and what better way to lift people up than recognize the significant things they may not realize they are doing,” said Ben Morris, director of storytelling for Creative Options Regina.

The non-profit organization, which offers support services and programs for people with disabilities, has been celebrating people in the city with its 100 Acts of Kindness campaign.

Morris and his team have sneaked into schools, community centres and onto city buses to surprise people and thank them for their work with small gifts like baking and T-shirts.

“You don’t actually have to know the person, or know the ins and outs of their life to recognize they have value,” he said.

Dr. Gordon Chin at the Victoria East Medical Clinic was another recipient of the 100 Acts of Kindness campaign. (CBC News)

The group finds some of its recipients through nominations on its website from people who want to show their appreciation for others who brighten their day, doing 10 acts per week through the campaign since in began in late January.

Feels good to give

Jesse, one of the people supported by COR, volunteered his own time before work for the 100 Acts of Kindness street team.

“It’s pretty fun bringing the T-shirts and cookies to people,” he said.

“It makes them happy.”

Morris and his team surprised Shea Beaudry, a COR support worker, with a nomination during Week 7 of the campaign. As Beaudry drove up to a client’s home, Morris and his team were waiting in the driveway.

Shea Beaudry, a COR support worker, says she was shocked to be acknowledged for her work. (CBC News)

Morris handed Beaudry a T-shirt, a button, stickers and home baking, and read out her nomination.

“When I felt alone, down and not worthy, Shea was there to fill me up and lift me up,” Morris read from the nomination by Maria Koback.

“Shea is one of the most empowering people in this world and I am so thankful to have met her.”

Beaudry was shocked by the acknowledgement.

“It just makes you feel better for doing what you do normally and being yourself,” she said.

The campaign will wrap up once the 100 acts are complete but Morris says he hopes it will inspire others.

In this season of giving, reporter Pamela Cowan is profiling some of the organizations and people working to make the lives of Reginans better. Watch for her stories for the rest of the year as we showcase the 12 Days of Difference-Makers.

Staff crowd around Andrew Ronnie and hug him as he blushes. It’s his 35th birthday.

One can feel the love inside the room.

Ronnie says softly: “Now I’m safe.”

It’s a feeling he hasn’t always felt. For many years, Ronnie didn’t feel loved and, in fact, was feared and shunned.

A number of years ago, he spent six months in the psychiatric unit at the Regina General Hospital. After his release, he was in and out of the emergency department.

No one could deal with the violent outbursts he was prone to until a group of special people uncovered his giving heart and his desperate need to feel safe.

He was the catalyst for the development of Creative Options Regina (COR) — a non-profit organization that develops personalized supports for people with a wide range of intellectual disabilities, and often mental health issues.

“They care about me a lot,” says Ronnie, the first person to receive COR services.

“What’s really important to understand is that these aren’t bad people,” says Michael Lavis, executive director of COR. “It’s just the system wasn’t flexible to be able to meet the needs of these folks to provide them with the care they required.”

And so, Lavis Says, COR started working with people “nobody else wanted.”

COR was created in partnership with the Ministry of Social Services in 2009.

A year before its creation, the provincial government identified 448 Saskatchewan people with intellectual disabilities and other complex needs who couldn’t access services — many from around Regina.

“We’ve seen families say, ‘We can’t do this anymore’ and they cut ties and that’s hard,” Lavis says. “I can only imagine how painful it is to drop their loved one off at the emergency room and abandon them. That’s happening all of the time.”

So COR, working with others in the community, connects individuals and their families with whatever services are required.

“Ultimately we’re providing support to everyone who is connected to that person’s life,” Lavis says.

The government gathered community-based organizations to discuss who required specialized services and how to provide them. Many were homeless, living in psychiatric units, shelters or hotels and two-thirds had a mental health diagnosis.

Complicating matters was that many were involved with multiple government departments.

“What happens to the people that touch two, three or four of those government departments?” Lavis asks. “What we know to be true is often they fall into these huge gaps that exist in our service delivery system.”

For example, people with mental health issues are the responsibility of the Ministry of Health. Those with intellectual disabilities deal with Social Services. Aboriginal people receive federal supports through Indian Northern Affairs Canada. Those under 21 fall under the Education Ministry and people in trouble with the law are involved with Justice and Corrections.

A number of adults connected to COR endured significant trauma while growing up in foster homes or group homes.

“Trauma that was inflicted upon them by the very people that were intended to protect them,” Lavis says.

Foster and group homes aren’t equipped to provide the supports these kids need, so they’re bounced around in the child and family system, he says. When they reach adulthood, they’re bounced around some more.

Supports through COR are tailored to each individual’s dreams.

Services range from daytime, recreational, supported living and employment supports. Depending on an individual’s needs, home supports might be provided for a few hours a day to 24/7 care.

Based on a companionship model, staff promote each individual’s independence.

“They might help them get up and get ready, grocery shop, prepare meals, do medication management and then help them connect with the broader community, both socially and recreationally,” Lavis says.

Many under the care of COR are society’s most disenfranchised.

When Ronnie moved to a home, he required two-on-one support around the clock. He couldn’t have a roommate because of his violent history.

“(He) came with case file after case file of all the horrific things he’s ever done in life,” Lavis says.

Candidly Ronnie confides he’s “had lots of temper and anger.”

But gradually Ronnie’s life was transformed. In 2012, he moved into a new home with a roommate and now receives one-on-one care.

“I’m working on no self harm and I’m working on not trashing the house — that was in the past,” Ronnie says proudly.

He hasn’t been to the hospital for more than a year, which Lavis credits to COR’s “gentle teaching” philosophy.

When dealing with behavioural issues, staff are taught: “Go for the centre. Mend the heart. All else will follow.”

Among those they had to mend was Gerald, a man with cerebral palsy who was unable to speak.

The first time Lavis met Gerald he was trussed tightly in his wheelchair with restraint upon restraint upon restraint. Boxing gloves and a helmet with face mask prevented the young man from hitting, pinching and biting those around him.

Gerald’s wheelchair was bolted to plywood to prevent him from toppling because of his constant thrusting.

“I remember looking at Gerald and thinking, ‘This is horrifying — straight out of a movie.’ Imagine, in 2009, that this exists in our own community,” Lavis says.

When COR staff started caring for Gerald the first thing they did was remove his restraints. There were ongoing struggles as he continued to pinch and bite.

“He couldn’t walk because he’d been in this wheelchair for so long that he had zero muscle capacity in his legs,” Lavis says.

While the team tried to build trust with Gerald, they gained a champion in the health-care system who discovered he had a bowel obstruction and dental issues.

“When we dealt with those underlying health conditions, the pain stopped and the hitting of the head stopped,” Lavis says. “Some of that violence that we saw was him trying to tell us, ‘I’m in pain. I hurt.’ ”

Eventually Gerald moved into a home with a roommate and has learned to walk unassisted.

“He has to hang on to the railings in the home, but there’s no helmet, no gloves, no restraints,” Lavis says.

***

Over eight years, the non-profit organization has grown to 170-plus employees who support more than 50 high-needs people.

“If there was a blanket diagnosis that I could give to everyone that we provide services to, I would say that it is a deep sense of loneliness,” Lavis says. “A deep sense of disconnect. These are folks who have very few, if any, true friends — unpaid, natural supports in their lives.”

Within that group of people, approximately 100 have been identified as having complex and challenging support needs. COR supports 19 of the 100 people.

Funded by the provincial and federal governments, COR has an operating budget of $7.8 million.

A number of COR participants have had lengthy stays in the mental health unit — the shortest being three months, the longest being 19 months.

“When you sit down and evaluate the cost of daily police interventions and all of the emergency room visits that happen weekly and the stints in the acute care settings — this is a fraction of the cost,” Lavis says.

To meet a growing need, Rory McCorriston, director of people and culture at COR, hired 30 employees in the past year.

“The majority of our organization is made up of support people,” he says.

The average age of staff is 28 — a good fit for the people they serve who are, on average, in their 30s.

It’s not uncommon for COR to hire people without previous disability experience.

“In some situations, it’s almost preferred because often if you have people who have done this type of work in a more traditional setting or have done it for a long time, they come in with their own set of ideas about caregiving,” McCorriston says.

Staff turnover is low and jobs aren’t posted because people send in unsolicited resumes after hearing COR’s story.

“In this industry of disability work, it’s common for an organization to have high staff turnover,” McCorriston says. “But when the basis of our philosophy of caregiving is building relationships, it’s hard to build a relationship if you’re only there for under a year.”

Staff help people gain abilities and return power to those who have felt helpless for years.

“Every day we’re hoping to come in — not to dress them, but to help them pick out the right outfit,” McCorriston says. “It’s not cooking and cleaning for that person, but doing it together.”

***

Chris, another young man, was a conduit for great change in Saskatchewan.

“He fell victim to that trap of living in the psychiatric ward for 19 months,” Lavis says. “Can you imagine, at a cost of $2,000 a day? He was there because there was no place for him to go.”

COR worked with Social Services and Regina Qu’Appelle Health Region’s Mental Health and Addictions Services to create supports for him. Provincial funding was used to hire a psychiatric nurse. Together they provide proactive mental health supports.

“Much better than queuing up at the emergency room and waiting for a six-month appointment with a psychiatrist, which is the norm,” Lavis says.

Another initiative rolled out two years ago after COR was asked to help a 14-year-old boy with autism who had significant behavioural challenges.

Executive director Michael Lavis. Michael Bell / Regina Leader-Post

“The system was really challenged to provide supports to him,” Lavis said. “Through that process, we changed our mandate to include youths and get involved earlier with these kids so we can put an end to that revolving door and they don’t fall off that cliff when they graduate to adulthood.”

Now COR supports youths who have intellectual developmental disabilities and mental health issues.

“Our hope — and I say hope because it hasn’t happened yet in the province — is that these kids are going to be able to transition from Child and Family programs to Community Living — the department within Social Services for disabilities — and the transition doesn’t disrupt their lives,” Lavis says.

This summer, COR opened its second youth home and currently provides 24-hour support for three individuals.

“The plan is to add another one or two kids this winter, but we’re also providing support to children who are living in the family home,” Lavis says. “Often the system forces the families to the brink and they have no other option, but to hand their child over to the system.”

More avenues opened four years ago for those with disabilities when COR partnered with Campus for All, a unique program at the University of Regina.

Every year, 12 students with intellectual disabilities participate in the inclusive post-secondary education program and convocate after four years.

“Campus For All was doing a fantastic job of the academic and social piece, but where they were struggling was the employment part,” Lavis says. “We have a number of folks really starting to thrive in the community and they want to work. They want a paycheque and they want meaningful work.”

To address that need, COR and Campus for All partnered to create 4 to 40, funded through the Ministry of Economy.

The employment initiative connects individuals involved in Campus For All and COR with employers who provide a flexible four-to 40-hour work week.

“Community employers want to be inclusive, they want to have diverse work forces and they understand the importance and the value that diversity brings, but they don’t really quite know how to do it and they need help — particularly with the demographic that we’re serving,” Lavis said. “There’s a lot of fear and apprehension around what that looks like.”

Employers are not subsidized and the paid employment includes benefits and pension.

Job descriptions and work hours vary, but the benefits of a meaningful job are the same — greater self esteem and inclusion.

“We have a guy working at the SaskTel warehouse that went from a few hours and now he’s up to 30 hours a week,” Lavis said.

Job coaches from COR help individuals integrate into the workplace.

“It’s really helping to set that person up for success,” Lavis says. “When I talk about success, I mean developing not only their skills, but connecting them to the relationships that come with any place of employment.”

***

Lavis is passionate about his work.

“So many people that we serve have been given such horrific labels and diagnoses — this laundry list of all these bad things they’ve done and these are some pretty amazing people… How do you give them that opportunity to shine so others can see that value as well?”

Prior to becoming one of the founders of COR, Lavis spent 12 years working with marginalized children and women in post-conflict zones around the world.

The 38-year-old worked on projects funded by the Canadian government, Oxfam in Great Britain and other international development organizations in places like northern Uganda and southeast Asia.

Back in Regina, Lavis insists he’s one of a team working to make a difference.

“We have this incredibly passionate young board made up of community professionals from varied backgrounds that are really committed to social change,” he says. “They don’t have a background in disability — most have zero connection, like myself, to disability. They’re very supportive of what we’re doing because they believe in the vision.”

When Serena Bernges, one of the younger residents of Valley View Centre in Moose Jaw, moved to COR in 2016 she was adamant she didn’t want to live with roommates or a group of people.

She wanted her own place in Regina.

Bernges has a soft spot for Valley View where she had friends throughout the institution, but she has new-found freedom in Regina.

The 43-year-old lives in a self-contained suite in a small bungalow with another woman. No longer does she share a bedroom and best of all, she gets to cook her own meals.

“I make stuffed mushrooms, lasagna and sausage and hot dogs,” Bernges says. “I live in the best house in the world.”

Michaelhttp://gentleteaching.com/wp-content/uploads/2016/06/logo-white.pngMichael2017-12-17 13:19:532017-12-17 13:19:53'Mend the heart. All else will follow': Creative Options Regina creates new life for many with disabilities

The following article addresses the culture found in residential settings where the quality of life is shaped by the multiple relationships between residents and direct care support staff. I was struck by the correlation between the elements of a culture of gentleness and what LaLoux has described in “Reinventing Organizations” as new level of organization emerging that holds great promise. (see “Book Corner”) The organizing principle in this new tier is the constellation of the deep values individuals are liberated to express in their work. – Clint Galloway, Editor

Those of us in the business of providing care for others often find ourselves trying to balance sound financial decisions with decisions that directly impact the quality of care provided. Tipping the balance negatively on the economic side (we can refer to them as “scale tippers”) include staff turnover, worker’s compensation claims, unemployment claims and the cost of training new staff, all of which can lead to increased anxiety for those we support, lower staff morale, reduced quality of care and increased expenses. If we can agree that the scale tippers attribute to a majority of the increased costs then we can agree that by reducing the incidents of scale tipping we will be making decisions that can lead to expansion, fewer vacancies and other business opportunities. Fortunately, we are learning that the same things attributed to reducing expenses are also attributed to increasing the quality of care for the individuals we support.

The ever changing landscape of our system of care pales in comparison to the changes experienced by those receiving care due to staff turnover. I recently went to my dentist and was informed that I would have a different dental hygienist. “What…no Dena?” I thought, “she’s been my hygienist for many years and suddenly they expect me to have my teeth cleaned by someone else?” (Maybe if I’d flossed regularly I’d be less concerned). The care that the new hygienist provided for me and my teeth was more aggressive than I’m used to, leaving me wanting Dena back. After my initial disappointment, I’m okay now with the notion of waiting six months to find out who will do my cleaning next. But I would be much less settled if I was to experience this uncertainty with every shift change, 547 times over the next six months. This uncertainty about whom we will be interacting with in a face-to-face relationship makes us feel less safe and precipitates negative feelings and actions. It invades the entire culture of care. It is an expensive drain on our resources as well as the peace of mind of those that we support.

Providers report an average turnover rate of 49% among frontline direct caregivers. For agencies that experience high annual turnover rates (hopefully you’ve calculated your annual rate, if not this would be a good first step to take), it is likely staff will leave within the first six months of employment. This is the period in which the initial, comprehensive training will occur for new staff. At an average replacement cost of approximately $3,500 per employee, these costs weigh heavily on the economic scale.

Other scale tippers that often appear in a workplace with excessive rates of turnover include worker’s compensation, health insurance premiums and unemployment claims. Worker’s compensation claims tend to increase when the people in our care feel unsafe and are more likely to be aggressive towards staff, resulting in injury. Insurance rates increase when claims expense increases, and conversely, rates remain more stable when claims expense decrease; in some cases refund checks are cut to providers when there is a well-established “culture of gentleness.” When excessive scale tipping is present we are more likely to find frivolous worker’s compensation claims. This can reduce morale, as well as your bottom line, due to time spent resolving the issues. Another hidden cost of high turnover is health insurance premiums. Decreased turnover means that a large health insurance claim can be absorbed over time if staff continues to be employed after the claim has been paid. Unemployment claims, whether you are reimbursing or a contributing provider can be incredibly time consuming and expensive, costing up to $10,000 a claim in some cases.

Not to be forgotten in the discussion are wages and benefits. These are significant factors in finding and retaining qualified staff. According to the Michigan Assisted Living Association’s (MALA) 2009 Strategies for Improving Wages, Benefits, and Training to Staff Providing Community Mental Health Funded Residential Services, “Wages for direct care workers among the providers responding to this survey are as much as $3.25 per hour less than wages in other similar sectors of long-term care.” Although it will not bring parity to our Medicaid reimbursement rates, an established culture of gentleness will increase our ability to offer more attractive incentives for our employees.

Now that we’ve identified the scale tippers, how do we begin to tip them in more favorable directions? We cannot support the people we support without feeling supported by the people who support us.

That sentence will gain few points from English teachers, but it does offer insight into what our focus must be if we want to create a culture that is conducive for healthy bottom lines and healthy hearts alike.

Have you ever heard of “seagull management?” This philosophy is indicative of a culture that offers little or no proactive support, and when things are not going well—for example, if a group home is in chronic upheaval—management (the seagulls) intervenes by providing plenty of white droppings to go around. The flock then flies off, leaving those covered in white droppings to rectify the scale tippers. So where do we need to focus if we want to prevent the seagulls from disrupting our day at the beach?

Creating a culture of gentleness starts with the leaders of organizations recognizing that the way we train, support, and maintain our employees ultimately has a direct effect on both the quality of care provided and staff retention. Just as those we support in our system of care strive for unconditional valuing, uplifting interactions, and encouragement so do our employees. We all do. It is imperative that all levels of management have an understanding of the six elements (safe, valued, praise, demand, structure, and transitions) that lead to a culture of gentleness. The key to higher quality training includes finding quality trainers and materials. The Center for Positive Living Supports (the Center) has been involved with supporting staff in numerous Mobile Response Training Unit deployments. Overall, we find that without understanding, commitment, and congruent behavior from the host provider and CMH staff, we often find an increased amount of scale tipping.

For example, our home managers play a vital role. Staff often quit a direct care position, not because of the people they support in the home, but rather the way they feel devalued by management. Many home managers also feel devalued from lack of support from above. One way in which we demonstrate our appreciation of the value of employees is by providing tools that give them the confidence to help create a supportive culture under complex circumstances. These tools come in the form of training and gaining a basic understanding of what we can do. In a best case scenario, it is estimated that 2% of annual budgets are earmarked for training. To use this effectively we need to incorporate ongoing support within the day-to-day culture and focus less on the external classroom. This requires developing trainers and recognizing that mentors play a vital role in creating and sustaining a culture of gentleness.

When the going gets tough, the mentors get going. Not exactly the adage with which we are all familiar, but a culture of gentleness requires us to invest in some of the more skilled staff, enabling them to become mentors. They are able to assist in some of our more difficult situations that traditionally may have escalated into scale tipping events. If you can build a capacity of at least one mentor for every 50 staff you will be investing in someone who has the skill set to assist in our most complex situations. The goal of mentoring is to create a sustained environment that will begin to make everyone that lives and works in the setting feel safer, more valued and less volatile. MALA’s findings, from their aforementioned 2009 study, concluded, “Education related to this culture of “gentleness” should be broadened throughout the state.”

According to projections from Michigan’s Department of Labor and Economic Growth (DLEG), employment in the state’s long term care industry is projected to grow by 20 % over the decade from 2006-2016, adding nearly 25,000 new positions. May I take you back to the dentist chair experience for a moment? When it’s time to see your dental hygienist wouldn’t you rather have Dena, whom you have grown to trust and respect? Me too, and for the same reasons the people receiving our care and those we employ will look to you, and want to stay with you. We need entire organizations that embody the elements that constitute a culture of gentleness. Working within an organization built on trust, mutual respect and valuing, dedicated to quality service, is like a sunny day at the beach engaging in experiences that can be meaningful and fun without worrying about Seagulls hovering overhead. They have also learned the prerequisites for landing and being warmly welcomed on the beach.

Example: Ayanna is extremely bright, has a wonderful sense of humour, likes to shop, and cares deeply about her family. She has had over 15 different placements over the past several years and more recently spent two-thirds of a year in psychiatric hospitals. Ayanna spent 45 days at the Transition Home and her future caregivers attended the preliminary training offered by The Center. When Ayanna moved to her new home, our staff worked for approximately three weeks with her caregivers during which time the six elements were demonstrated, coached, and observed by the Mobile Response Team Mentor. Her current provider remains committed to supporting her in her home and for the past year she has lived successfully in her home having only been hospitalized for a week.

Ed Kiefer, B.S., L.B.S.W
The Center for Positive Living Supports, an affiliate of Macomb-Oakland Regional Center.

http://gentleteaching.com/wp-content/uploads/2016/11/Why-a-culture-of-gentleness-Feature.jpg3111000brandonwumecomhttp://gentleteaching.com/wp-content/uploads/2016/06/logo-white.pngbrandonwumecom2014-11-02 21:24:342016-11-01 21:16:41Why a Culture of Gentleness Makes Good Business Sense